Hallelujah acres address 2009

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  • Lab values out of control…..Glucose in the 400-500’s, ….After determining why she was here I stopped and asked if she knew what caused her diabetes….and how her dit was…
  • The faucet of preventable disease is overflowing on the floor and as we respond with an acute care, emergent response very few people are reaching for the faucet.
  • Modifiable behavioral risk factors are leading causes of mortality in the United States. (JAMA, 2000 Mokdad et al. CDC)
  • Modifiable behavioral risk factors are leading causes of mortality in the United States. (JAMA, 2000 Mokdad et al. CDC) www.cdc.gov/cancer/ breast/statistics/ http://www.cdc.gov/cancer/Prostate/publications/decisionguide/
  • www.cdc.gov/cancer/ breast/statistics/ http://www.cdc.gov/cancer/Prostate/publications/decisionguide/
  • --http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/obesity.pdf --http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/obesity.htm
  • --http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/obesity.pdf
  • http://www.cdc.gov/diabetes/statistics/incidence/fig1.htm
  • --http://www.ncbi.nlm.nih.gov/pubmed/12679416-- --http://www.chrp.org/pdf/HSR10_08_04.pdf --http://www.nchc.org/facts/cost.shtml --Catlin, A, C. Cowan, S. Heffler, et al, "National Health Spending in 2005." Health Affairs 26:1 (2006): 142-153. --Borger, C., et al., "Health Spending Projections Through 2015: Changes on the Horizon," Health Affairs Web Exclusive W61: 22 February 2006. -- http://www.mathematica-mpr.com/health/ --http://aspe.hhs.gov/health/NDAP/NDAP04.pdf
  • All prices from pharmacychecker.com Generics selected for pricing purposes All values based on recc. Therapeutic use
  • -- 6/22/02 radio address :Americans who are obese spend approximately 36 percent more on health care services than the general population. They spend 77 percent more on medications. --Catlin, A, C. Cowan, S. Heffler, et al, "National Health Spending in 2005." Health Affairs 26:1 (2006): 142-153.2.Borger, C., et al., "Health Spending Projections Through 2015: Changes on the Horizon," Health Affairs Web Exclusive W61: 22 February 2006. -- http://www.mathematica-mpr.com/health/ --http://www.nchc.org/facts/cost.shtml
  • http://www.who.int/research/en/
  • --http://findarticles.com/p/articles/mi_m0795/is_n4_v15/ai_15868836/pg_2 -- our of the six countries have 2.2-3.1 physicians per capita, and the other two (Japan, United Kingdom) have roughly 1.5 physicians per capita. This compares with 2.3 per capita in the United States. However, the specialty distribution of physicians is strikingly different between the United States and the other countries. In the United States, only about 33 percent of all physicians declare themselves to be primary care physicians (Politzer et al., 1991). This contrasts with the other countries, which have predominantly primary care physicians (53-63 percent) (Chaulk and Bialek, 1993; Rodwin et al., 1990; Fielding and Pierre-Jean, 1993; McAuley, 1992).
  • --http://www.who.int/whr/en/ -- (behind such notables as Oman, Saudia Arabia, Portugal etc.)
  • --http://www.healthierus.gov/STEPS/summit/prevportfolio/power/index.html#we --1in 4 health care dollars spent to treat HTN, Obesity, High lipids and diabetes
  • We are all painfully aware of the ongoing challenges in our economy; the subprime mortgage market, job losses, questionable solvency of the SSA, and even fortune 500 companies suffering from excess costs and reduced margins. In fact according to Business week, the only new job market has been the industrial medical complex.
  • --How did folks like JW get into such straits?
  • -- President’s Address on 6/22/02 :Americans who are obese spend approximately 36 percent more on health care services than the general population. They spend 77 percent more on medications.
  • -- http://www.ers.usda.gov/briefing/consumption/Effects.htm
  • --IOM rec on Na: AI 1.5g/d UL 2.3g/d --http://www.cspinet.org/ --http://www.ama-assn.org/ama/pub/category/16461.html -- http://www.iom.edu/?id=18495&redirect=0 -- Dr. Heikki Karppanen of the University of Helsinki and Dr. Eero Mervaala of the University of Kuopio report that an average 30-35 % reduction in salt intake during 30 years in Finland was associated with a dramatic 75 % to 80 % decrease in both stroke and coronary heart disease mortality in the population under 65 years. During the same period the life expectancy of both male and female Finns increased by 6 to 7 years.The most powerful explaining factor for the favorable changes was the more than 10 mmHg ("point") decrease in the average blood pressure of the population. A marked decrease in the average cholesterol levels of the population also remarkably contributed to the decrease of heart diseases. The extensive use of drugs contributed less than 10 % of the observed decreases in blood pressure, cholesterol, and cardiovascular diseases. -- http://www.iom.edu/Object.File/Master/20/004/0.pdf http://fnic.nal.usda.gov/nal_display/index.php?info_center=4&tax_level=3&tax_subject=256&topic_id=1342&level3_id=5140
  • --http://www.ers.usda.gov/publications/foodreview/jan1996/frjan96a.pdf
  • --Or as Dr. Goldhamer likes to say…that is a lot of Cow Puss Folks
  • ---- http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/obesity.htm -- http://www.ers.usda.gov/briefing/consumption/Effects.htm -- http://www.agmrc.org/agmrc/markets/Food/foodconsumptiontrends.htm
  • -- http://www.cdc.gov/nccdphp/dnpa/physical/index.htm -- http://www.cnn.com/2003/HEALTH/diet.fitness/08/15/cdc.exercise.ap/
  • Remember that an av. Inc. in caloric intake of 500KCal/day results in an av. weight gain of 1lb per week
  • 6/22/02 radio address :Americans who are obese spend approximately 36 percent more on health care services than the general population. They spend 77 percent more on medications.
  • -- http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/obesity.htm --http://www.nhlbi.nih.gov/health/prof/heart/hbp/salt_upd.pdf --http://www.nhlbi.nih.gov/health/prof/heart/hbp/salt_upd.pdf --http://www.usatoday.com/news/health/2008-02-10-salt-dangers_N.htm -- Intersalt Cooperative Research Group (1988). Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. BMJ . 297 : 319–328. --The contradictory nature of these findings accords with the unreliability of the methods used in NHANES III and IV (ie, 24-h dietary recall). Twenty-four-hour urinary sodium from complete urine samples is the only accurate way to estimate dietary salt intake, and this was not measured in NHANES III and IV. The large international study—INTERSALT, 2 which had 24-h urinary sodium and BP measured, showed that salt intake is directly associated with BP and the increase in BP with age in more than 10,000 individuals including both hypertensives and normotensives. -- -- http://www.nhlbi.nih.gov/new/press/nov30a99.htm -- Healthy adults living in a temperate climate can maintain a normal sodium balance with as little as 115 mg of dietary sodium per day. In consideration of the wide variation in Americans’ physical activity and climatic exposure, a safe minimum of 500 mg of sodium per day has been recommended. -- Dr. Heikki Karppanen of the University of Helsinki and Dr. Eero Mervaala of the University of Kuopio report that an average 30-35 % reduction in salt intake during 30 years in Finland was associated with a dramatic 75 % to 80 % decrease in both stroke and coronary heart disease mortality in the population under 65 years. During the same period the life expectancy of both male and female Finns increased by 6 to 7 years.The most powerful explaining factor for the favorable changes was the more than 10 mmHg ("point") decrease in the average blood pressure of the population. A marked decrease in the average cholesterol levels of the population also remarkably contributed to the decrease of heart diseases. The extensive use of drugs contributed less than 10 % of the observed decreases in blood pressure, cholesterol, and cardiovascular diseases. -- http://www.iom.edu/Object.File/Master/20/004/0.pdf http://fnic.nal.usda.gov/nal_display/index.php?info_center=4&tax_level=3&tax_subject=256&topic_id=1342&level3_id=5140
  • ---http://win.niddk.nih.gov/publications/energize.htm --http://www.ama-assn.org/ama/pub/category/17091.html --http://www.cdc.gov/nccdphp/dnpa/physical/index.htm --http://www.americanheart.org/presenter.jhtml?identifier=1200009 --http://www.fns.usda.gov/eatsmartplayhardhealthylifestyle/ --http://www.fda.gov/hearthealth/lifestyles/lifestyles.html --http://www.who.int/topics/obesity/en/
  • -- Bull World Health Organ. 2002;80(12):952-8. Epub 2003 Jan 23. Chopra M et al
  • --There is unanimous agreement that meaningful lifestyle change must be at the heart of re-0birth for our nation.
  • --Fraser et al. Archives of IM: 2001:161;1645-1652
  • --Am J Clin Nutr. 1999 Sep;70(3 Suppl):532S-538S.
  • A belief in Our Lord Jesus Christ and in the potential of the human person. You see ours is a message of hope, of promise, of potential for a world broken, hungry, scared, lost and fallen. We offer not only the saving relationship with Christ but an earthly lifestyle that can provide us with a rich, vital and energetic life. We offer a heritage of ….
  • Understand and prioritize the dialogue. Does this person need one on one time, group time, stories, studies…..even more critical do they need Jesus or do they merely need a physical tune up?
  • --Cooper Center in Texas --Lifestyle Centers of America in Oklahoma --Rippe Health in Massachuesets --Pritikin in Miami --Newstart in CA
  • --Dean Ornnish MD PRI --Neal Barnard MD PCRM
  • Mainstream medicine and our mainstream world fails to create relationships. But at the heart of every therapeutic…every healing interaction is a relationship. Knowing someone cares and I am cared for is often reason enough to inspire a change of heart or to motivate to greater efforts. Ex: A couple meets and they like each other. The desire for and recognition of a relationship of being “cared for” is prompts action….the man may be willing to shed a few pounds, cut his hair more often, clean his nails, and his significant other to do her hair up to dress in his favorits colors and make his favorite foods.
  • The Tipping Point Malcolm Gladwell
  • Hallelujah acres address 2009

    1. 1. An Address to HallelujahAcres Annual Gathering 04/18/09 Stephan Esser MD www.esserhealth.com
    2. 2. Hallelujah Acres 2009 Leading the way to a healthier America! Stephan Esser M.D 04.18.09
    3. 3. Message• Sorrow, fear, decay• Hope, joy, potential
    4. 4. Or……….• Present a Problem• Discuss the Solution• Confer your Challenge
    5. 5. Key Concepts• How is healthcare in America?• How did we get here?• How can we make a difference?• Tools to Use
    6. 6. Julia Watkins34 y/o Obese Female• DM2, HTN, Hyperlipidemia, Claudication, Peripheral Neuropathies, Lower Back Pain, Depression• Medx: HCTZ, Lisinopril, ASA, Insulin L/Novo, Glipizide, Lipitor, Plavix, Cilostazol, Gabapentin,Tylenol prn, Prozac, Prilosec,
    7. 7. US Healthcare Today!
    8. 8. In America Today • We spend too much • We apply too little to prevention • We die by our knives and forks
    9. 9. Leading Causes of Death in US
    10. 10. Actual Causes of Death in US
    11. 11. Michelangelo’s David: 12 month 20 city tour of the US
    12. 12. Associated Pathology • CVD: • Obstetrics: – Hypertension – Gestational DM – Congestive Heart Failure – Macrosomia – PVD – Inc. C Section rate – Impotence – Inc. Perinatal Morbidity • DIABETES – Claudication Endocrine: – Diabetes • – Inc. Pre/Eclampsia Cancer: – Prostate – PCOS – Colon – Hypothyroidism – Breast – Infertility – Endometrial • Orthopedics: – Renal Cell – Osteoarthritis – Gallbladder – AVN – Esophageal Adeno. • Hepatic: • Other: – #1 cause of liver dz in US • Hyperuricemia, Pancreatitis, Gallstones, Sleep Apnea, Alzheimer’s, Dyslipidemia, Metabolic Syndrome
    13. 13. Overweight ↑ risk of DM2 by 3 foldObesity ↑ risk by 9 fold
    14. 14. Visceral Adiposity/Belly Fat/Apple Fat
    15. 15. Diabetes is the #1 cause of…. – Kidney Failure – Amputation – Blindness
    16. 16. Cost to the Nation• Over 20.8 million Americans have diabetes (CDC 2005).• Healthcare is 2-3 times that of those without DM(WHO)• Projected $156 billion by 2010 and $192 billion in 2020• Perspective• Cost of DM2 care in 2005 > budget of the D. of Ed.• Diabetes care is 12 percent of the total federal health care spending nationwide—roughly one of every eight dollars.
    17. 17. JW’s Monthly Drug costs• Hctz $19 QD• Lisinopril $26.14 QD• Januvia $75 QD• Glipizide $13.80 BID • Cost: $394.04• Asa $7.96 QD• Lipitor $19.80 QD Cilostazol $50 BID Plavix $33.3 QD • # Pills/day: >15• Gabapentin $66.95 TID• Tylenol $1.00 prn• Prozac $44.49 QD • Annual Cost:• Prilosec $45.90 QD >$4800
    18. 18. Total Healthcare Spending • $2.3 TRILLION in 2007, or $7,600 per person • 16% of the gross domestic product (GDP) • Projected to exceed $4 TRILLION by 2015
    19. 19. Chart of Spending-2 times as much as Canada -3 times as much as Britain - > 60% privately funded
    20. 20. • Spend more per capita than any other country on earth• U.S. is 37th in the global health rankings
    21. 21. Financial Expenditures• Chronic Dz ≈ 75% of health care costs – Acc. to Dept of HHS: • CVD and CVA $351.8 billion (2003) • Cancer $171.6 billion (2002) • Diabetes $132 billion (2002) • Obesity $117 billion (2000) • Arthritis $82 billion (1995) • Smoking DMC $75 billion LP $80 billion • Physical Inactivity $76 billion (2000) • Poor Nutrition DMC $33 billion LP $9 billion
    22. 22. Economic Woes
    23. 23. We spend more yetwe are one of the sickest most obese over-medicatedsocieties on Earth!
    24. 24. How did this happen?
    25. 25. Genetic Shift or LifestyleChoices?
    26. 26. ↑39%Av. of 52 tsp added sugar/person/day
    27. 27. •IOM: (UL) for salt is 5.8 g/day > 95 percent US Males 31 - 50 > 75 percent of US females 31- 50 regularly in excess of the UL.
    28. 28. ↑66%
    29. 29. ↑57 lb/capita
    30. 30. ↑400%
    31. 31. 60% ↓ insweetenersVegetables 10%↑ in4×’s↑dark green/yellowveggies 3 ×’s ↑dry beans, peas and lentils ↑ 114-150% in fruit 36% ↓ in total fat
    32. 32. What about Exercise?
    33. 33. US Gov. Reccomendations 30 minutes/day 30 minutes per day for 4-5 days a week 4-6 days/week
    34. 34. Perspective • We eat more – Sugar, Salt, Meat, Dairy, Fat – 1970-2000: • ↑ 24.5 % C/day ≈ 530K/day • We get far less then ideal – Exercise
    35. 35. Wehave a problem of epidemic proportions!
    36. 36. Joe and his Car
    37. 37. What is the answer?
    38. 38. What if……….. …….we ate MORE fruits,vegetables,whole grains and legumes…. ………we ate l e s s meat, fish, dairy, eggs, oil, sugar and salt & increased our exercise habits!
    39. 39. Some Say……. – If 10% of adults began a regular walking program, $5.6 billion in heart disease costs could be saved. – If Americans↓ Na intake by 2300mg/day = 3-6 mm Hg ↓ in SBP • 11 % ↓ strokes • 7 % ↓ coronary events • 5 % ↓ total mortality
    40. 40. “A global response to aglobal problem: the epidemic of overnutrition.” WHO 2002 It is estimated that by 2020 2/3 rds of the global burden of disease will be attributable to chronic noncommunicablediseases, most of them strongly associated with diet. The nutrition transition towards refined foods, foods of animal origin, and increased fats plays a major role in the current global epidemics of obesity, diabetes and cardiovascular diseases, among other noncommunicable conditions. Sedentary lifestyles and the use of tobacco are also significant risk factors. …….. A concertedmulti-sectoral approach, involving the use of policy, educationand trade mechanisms, is necessary to address these matters.
    41. 41. All Major Health Institutions• Encourage: – Inc. Consumption of Fruit and Vegetables – Inc. Fiber Intake – Inc. Exercise – Weight Loss – Reduce Salt intake – Reduce Fat Intake – Reduce Cholesterol Intake – Effective Stress Management
    42. 42. “Not only do persons with better health habitssurvive longer, but in such persons, disability ispostponed and compressed into fewer yearsat the end of life.”Vita, AJ et al. NEJM 1998; 338:1035-1041
    43. 43. 50% ↓ in all-12 year Cohort Study1507 men 832 WomenAges 70-90 years cause and causeOutcomes: 10 yr all cause mortality4 Factors: Med. diet, Moderate EtOH, physical exerciseand non-smoking were ass. w ↓ in ACM specific mortality
    44. 44. Who does that sound like?
    45. 45. Hallelujah Acres
    46. 46. You have the answer to….• Emptiness, loneliness, lack of purpose• A host of common disease processes – Obesity – Cardiovascular Disease – Type Two Diabetes – Much of Cancer Risk
    47. 47. In Perspective• Disease Epidemic• Personal Choices• We have the answer
    48. 48. Now What…….Called to Action RespondedNourished Celebra Motivated te
    49. 49. Our Mission• Educate Enlighten• Empower Convert• Motivate Restore
    50. 50. Tools to Use: Educate• Know: Our plans miscarry because they have no aim. When a man does not know what harbor he is making for, – Your Intentions no wind is the right wind.-Seneca- – Your Audience – Your Limitations
    51. 51. Educate• Know: – Your Resources – Your Colleagues
    52. 52. Individuals
    53. 53. Organized Facilities
    54. 54. Policy-Making/P.H. Promotion
    55. 55. Community Based
    56. 56. Empower– Create Relationships–Identify Needs/Goals– Create Value
    57. 57. Motivate• Through – Personal Example – Personal Testimony – Vicarious Experience
    58. 58. Tipping Point• Create an epidemic of good health• Identify personal “Circle of Influence”• Positive, contagious behavior• Small changes have big effects• Change happens rapidly
    59. 59. A GiftTo whom much has been given much shall be expected! Luke 12:48
    60. 60. 2009• Need• Answer• Evidence• Obligation• Mission
    61. 61. Let’s restore the hearts and minds of America, one life at a time!
    62. 62. Thank You !
    63. 63. Thank you! For more Health information visit www.esserhealth.com

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